1. Quantitative Evaluation of Surgical Skills Learned in Simulation
John Ferrara MD, Kanav Kahol PhD,
Aaron Ashby MS, Marshall Smith MD
Phoenix Integrated Surgical Residency
Simulation and Education Training Center
Banner Good Samaritan Medical Center
Phoenix, Arizona

2. Background Surgical Skills in Simulation
Validated as an environment to teach surgical skills
Aggarwal et al: transferrable
Endovascular surgery
Laparoscopic surgery
Durability
Stefanidis et al
Hiemstra et al
Shortcomings
Time-course analysis
Cognitive loading

3. Hypotheses
Technical and cognitive skills learned through scripted exercises in a simulated environment deteriorate over time
Skill recovery can be achieved in a simulated environment with fewer iterations of scripted exercises

4. Study Design Ten PGY-1 residents Eight ring transfer exercises wearing
DataGloves
Cognitive variations
Attention
Memory
Orientation
Movement proficiency

5. Study Design Ring Transfer Tasks
Basic Exercise
Working Memory Exercise
Attention Exercise
Orientation Exercise

6. Study Design Baseline established over one month
Ten iterations of each of the eight exercises
Post test to establish baseline performance
Retention study every month for six months
Two iterations of six randomly chosen exercises
Deterioration curve established
Iterations continued until within 1% of baseline

7. + * #
*p<0.05
+p<0.032
#p<0.02 # + *

8. *
*p<0.04 * *

9. Discussion Results kind of make sense Why four months?
More (too) sensitive measurement instruments?
Cognitive loading
Why four months?
Concomitant surgical experience
Warm up effect
Remediation less rigorous

10. Conclusions Skills learned through simulation deteriorate over time
Deteriorated skills can be readily re-captured
Future work
More experienced surgeons
More complex tasks